Appointment scheme at Bromsgrove GPs' cuts A&E admissions

A NEW appointments system introduced to Bromsgrove's Davenal House GPs' practice more than 18 months ago has cut the number of patients on the surgeries' books going to A&E by 20 per cent.

And one of the partner GPs Dr Adam Lee feels that if Doctor First was introduced to more practices across the county, it could have a massive impact on overall Accident and Emergency numbers.

Davenal House, which has surgeries in Bromsgrove town centre and Stoke Prior, became one of several practices across the county to trial Doctor First in 2012.

The system sees patients ring the surgery with their symptoms and the doctor calls them back - usually within 30 minutes. If after a phone consultation, the GP feels it necessary to see the patient or if the patient still wants an appointment, a slot can be booked that day. Or, if it can be dealt with in another way, the patient is advised to do that.

Because only about a third of phone consultations lead to face-to-face appointments, GPs are able to help double the number of patients they can help each day and appointments are always available. Doctors also have the flexibility to offer longer appointment times to those who really need it.

Dr Lee said: "In the past, it was done on a first come, first serve basis and it was often whoever was the most persistent who got the appointments which, clinically, wasn't very fair. It was a lottery not influenced by clinical need.

"The decision was made by the receptionist and the patient, now it is made by the clinician and the patient.

"We are making a clinical decision on the day as to what is needed and we can also schedule more accurately the length of time an appointment needs to be."

He added that if people found it difficult to get an appointment with their GP, they were more likely to turn to A&E.

As well as the drop in A&E attendances and out of hours clinics, improved clinical outcomes, such as quicker diagnosis of cancer, and less missed appointments have also been attributed to Doctor First's introduction.

There was a lot of scepticism and complaints when the system was first introduced, but Dr Lee said that had dropped dramatically.

"It wasn't easy to start with and involved a huge change in attitude from doctors, other staff and patients."

He added it was, initially, a lot of work, but, he said, if other practices embraced Doctor First, it could have a massive impact on A&E admissions.

"Assuming they could mirror the same reductions in A&E attendance that we have achieved, the affect could be dramatic.

"It's one method that could provide a long-term solution to the problems being faced by A&E."

Sue Price, director of commissioning for NHS England in Arden, Herefordshire and Worcestershire, said: “We are pleased to hear of the success that Davenal House surgery has had using the Doctor First system.

"NHS England would encourage other GP practices to consider adopting this or other similar approaches which help to ensure that patients are able to access the most appropriate healthcare when they need it.”